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Hospital de Órbigo, Spain

Villar J.M.,Virgen Of Las Nieves Universitary Hospital | Moreno P.,Bellvitge Universitary Hospital | Ortega J.,Clinico Universitary Hospital | Bollo E.,Donostia Hospital | And 16 more authors.
Langenbeck's Archives of Surgery | Year: 2010

Purpose: Given the availability of laparoscopy and the rising detection of incidentalomas, indications for adrenalectomy may be changing. The Endocrine Surgery Section of the Spanish Association of Surgeons designed a survey to assess its indications, techniques, and results in Spanish Surgical Departments. Methods: Collected data included hospital and department type, yearly hospital volume of procedures; location studies and preoperative preparation performed, indications, surgical approach and instruments used, and results in terms of morbidity and overall hospital stay. The analysis included a comparison between results of high- or low-volume centers and surgeons, using the Student's t test for quantitative and chi-square test for qualitative variables. Level of significance was set at 0.05. Results: Nineteen centers returned the questionnaire, including 155 adrenalectomies performed in 2008. Most frequent indications were pheochromocytoma (23.2%), aldosteronoma (16.7%), incidentaloma (12.2%), metastasis (10.3%), Cushing adenoma (9.6%), and carcinoma (3.8%). Laparoscopy was performed in 83.9% of cases (9.4% required conversion to laparotomy). Four patients required urgent reoperation. Average hospital stay: 4.6 days (3.3 days after laparoscopy, 7 days after laparotomy). High-volume centers had a greater proportion of laparoscopically treated cases (p∈=∈0.008), more malignant lesions treated (p∈=∈0.03), a shorter overall stay (p∈<∈0.0001), and a shorter stay after laparotomic adrenalectomy (p∈=∈0.01). High-volume surgeons had similar results, and less in-hospital morbidity (p∈=∈0.02). Conclusions: In Spain, adrenalectomy is performed in hospitals of varying complexity. Laparoscopic approach is the rule, with good results in terms of morbidty and stay. High-volume centers and surgeons had best results in terms of use of minimally invasive surgery and hospital stay. © 2010 Springer-Verlag.

Roses L.,Xeral Calde Hospital | Ortiz C.,Xeral Calde Hospital
Frontiers of Gastrointestinal Research | Year: 2010

Percutaneous endoscopic gastrostomy (PEG) has become one of the most frequently used procedures to administer nutrition and also as an alternative to the surgical approach or nasogastric tubes. The technique is simple, safe and cheap; it can be performed by any moderately experienced endoscopist and so, since the original description in 1980, has become a popular method around the world. The main PEG indication is the nutrition of patients that cannot swallow, although there are other utilities. Contraindications and complications are very unusual in clinical practice. There are three technical modalities for the placement of the gastrostomy tube, with no one being better than the other. This chapter tries to explain in a very practical way the main aspects of the procedure and it especially focuses on technical points, incorporating some useful tricks that can help solve some eventually embarrassing situations. Copyright © 2010 S. Karger AG.

Garcia-Bermudez M.,Institute of Parasitology and Biomedicine of the Spanish National Research Council IPBLN CSIC | Lopez-Mejias R.,Santander University | Gonzalez-Juanatey C.,Xeral Calde Hospital | Castaneda S.,La Princesa University | And 9 more authors.
Scandinavian Journal of Rheumatology | Year: 2012

Objective: The methionine sulfoxide reductase A (MSRA) gene is related to oxidative stress that has been involved in the susceptibility to rheumatoid arthritis (RA) in genome-wide pathway analysis and replication studies. The aim of the present study was to determine whether the MSRA gene is implicated in susceptibility to cardiovascular (CV) disease in RA patients. Methods: A total of 1302 patients fulfilling the 1987 American College of Rheumatism classification criteria for RA were genotyped for the MSRA rs10903323 (G/A) polymorphism. Two hundred and thirty-three (17.9%) patients experienced CV events. Human leucocyte antigen (HLA)-DRB1 genotyping was performed using molecular-based methods. Multiple logistic regression models were constructed with adjustments for gender, age at RA diagnosis, follow-up, rheumatoid shared epitope, and traditional CV risk as potential confounders. Results: There were no statistically significant differences in the allele or genotype frequencies for the MSRA rs10903323 polymorphism between RA patients who experienced CV events and those who did not. However, an adjusted logistic regression model disclosed that the minor allele G yielded a marginally significant increased risk of CV events in this series of patients with RA [p = 0.05, odds ratio (OR) 1.68, 95% confidence interval (CI) 1.00-2.85]. When the logistic regression model was adjusted for anti-cyclic citrullinated peptide (anti-CCP) antibody status instead of for shared epitope, an increased risk of having ischaemic heart disease was found in patients carrying the minor allele G (p = 0.04, OR 2.00, 95% CI 1.03-3.88). © 2012 Taylor & Francis on license from Scandinavian Rheumatology Research Foundation.

Monte R.,Xeral Calde Hospital | Rabunal R.,Xeral Calde Hospital | Casariego E.,Xeral Calde Hospital | Lopez-Agreda H.,Xeral Calde Hospital | And 2 more authors.
Alcohol and Alcoholism | Year: 2010

Aim: To investigate the clinical variables associated with the risk of dying and the causes of death during the course of alcoholic withdrawal syndrome (AWS) in a general hospital. Methods: Cohort study of AWS patients admitted to Xeral Hospital in Lugo, Spain between 1987 and 2003. The characteristics of patients who died were contrasted with those who survived. The different clinical, epidemiological and biochemical variables reflective of alcohol consumption habits, basal health status and presentation features of the syndrome and its complications were all recorded. Results: There were 539 episodes of hospitalization for AWS in 436 patients (mean age 45.0, SD 12.0, 91.3% males), 71.1% of whom presented with delirium tremens. A total of 29 patients died, yielding a 6.6% mortality rate (95% confidence interval, CI: 4.2-9.1%). Eighteen patients (62%) died after being admitted to the intensive care unit (ICU). The following independent variables were associated with the risk of dying in a multivariate logistic regression model: cirrhosis [odds ratio (OR) 4.8 (95% CI 1.5-14.6), P=0.006]; presenting with delirium tremens at diagnosis [OR 3.5 (95% CI 1.3-8.9), P=0.008]; the existence of an underlying chronic pathology other than liver disease [OR 2.5 (95% CI 1-6.1), P=0.01]; and the need for orotracheal intubation [OR 2.9 (95% CI 1.1-7.9), P=0.03], especially if pneumonia requiring ICU is added [OR 8 (95% CI 3-21.3), P<0.001]. Receiver operating characteristic analysis revealed an area under the curve of 0.818 (95% CI 0.742-0.894). Conclusions: The factors determining survival after admission to a general hospital for alcoholic withdrawal syndrome depend on the intensity of clinical manifestations (delirium tremens, ICU, orotracheal intubation) and the presence of associated comorbidity. © The Author 2010. Published by Oxford University Press on behalf of the Medical Council on Alcohol.

Nunez R.,Xeral Calde Hospital | Carballada F.,Xeral Calde Hospital | Lombardero M.,Xeral Calde Hospital | Jimeno L.,Xeral Calde Hospital | Boquete M.,Xeral Calde Hospital
International Archives of Allergy and Immunology | Year: 2012

Background: The role of profilin as a food allergen is well established, but little research has been done about its ability to elicit respiratory disease. Profilin is considered more of a confounding allergen on skin testing with whole pollen extracts than other airborne allergens. Our aim was to find out whether or not profilin can cause symptoms in sensitized individuals, which would be compatible with its role as an airborne allergen. Methods: We performed conjunctival allergen challenges with date palm profilin in a series of consecutive pollen-allergic patients with rhino-conjunctivitis, divided in two groups: profilin sensitized (n = 17) and not sensitized (n = 14), who served as controls. We investigated the possible association between profilin sensitization and profilin allergy in these groups of patients. Results: None of the patients from the not profilin-sensitized group had a positive result in conjunctival allergen challenges. In contrast, 65% of profilin sensitized patients had a positive conjunctival allergen challenge and were considered allergic to profilin. We found a significant statistical association between being profilin allergic and being profilin sensitized (χ 2 = 10.39, p < 0.005). Conclusions: Profilin seems to work as an aeroallergen in a significant proportion of profilin-sensitized patients. This might explain the uselessness of conjunctival challenges with whole pollen extracts to disclose genuine sensitization. In the future, the possibility of quantifying this allergen in pollen immunotherapy vaccines should be considered. Copyright © 2012 S. Karger AG.

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